Is it time you started taking testosterone?
To many, Dan Hegarty’s experience of hitting his forties will sound depressingly familiar: he was tired, irritable, his body ached and he had lost his joie de vivre. “Every afternoon, I would have a lull in my energy levels,” he says. “My concentration wasn’t as good as it used to be – I couldn’t even concentrate on a newspaper. I wasn’t sleeping so well, and my libido had dropped off.”
Today, that version of himself seems a distant memory, thanks, he believes, to the testosterone gel he has been rubbing into his skin. He says he feels younger, more energetic and less tired.
“It makes you feel better and livelier, and your confidence comes back,” says Hegarty, now 60, who lives in Chislehurst, Kent, and is married with one son and two stepchildren.
“I also had a lot of muscle aches, which I found went after about a month of starting on testosterone.”
The treatment has also had a positive effect on his libido. “All those things make you feel more interested in that aspect of your life. If you’re tired all the time, it doesn’t exactly help with action in the bedroom.”
Testosterone use is soaring – prescriptions for it on the NHS have more than doubled in the past 10 years, according to analysis by Pulse magazine.
The synthetic form of the hormone, derived from plants, can be given through injections – singer Robbie Williams revealed in 2011 he had been having the jabs – but is now available in the form of gels, lozenges or creams, making dosage easier to manage.
And it’s not just men who are driving the testosterone trend: increasing numbers of women are taking small doses of the hormone to help with flagging sex drive, low energy and mood. Last week, Nick Panay, consultant gynaecologist at Chelsea and Westminster Hospital NHS Trust, called for women to be offered testosterone on the NHS.
Hegarty, a qualified doctor who now runs an occupational health company, started taking testosterone after reading an article in a journal. He went to see Dr Malcolm Carruthers, a leading advocate of testosterone treatment in the UK, and started a course after a blood test and symptom history confirmed that his levels were low. That was 19 years ago; he saw Dr Carruthers privately but receives testosterone on the NHS from his GP.
Dr Carruthers believes up to 30 per cent of men could benefit from a testosterone supplement. He says the rise in prescriptions is driven in part by the fact we are living longer and expecting more from our later years.
“Testosterone adds life to your years as well as years to your life,” he says. “The benefits are wide-ranging and not just related to libido and erection problems.
“It helps men lose weight and prevents and improves diabetes; it strengthens the bones, reducing the risk of a fracture.”
Although symptoms of low testosterone are similar to those of the female menopause, he says the condition is not simply a result of ageing and can occur as a result of stress, weight gain or certain medications such as finasteride – used to prevent baldness – and blood-pressure-lowering drugs.
Not everyone is convinced by the wider use of testosterone, however. Many doctors say that symptoms of low testosterone would be better addressed with lifestyle changes – for example, losing weight, exercising and reducing alcohol intake. Dr Carruthers argues, however, that many middle-aged men struggle to lose weight, regardless of doctors’ urging. “If they’re low on energy, they just won’t do it. It’s not until they get a boost from testosterone that they can start doing things such as taking exercise.”
Another issue is the measurement of testosterone: levels fluctuate hugely and, unlike in the female menopause where a clear drop in oestrogen can be easily shown in a blood test, the fall in testosterone can be much more subtle. “It’s not like there is a foolproof test,” says Dr Mark Vanderpump, an endocrinologist at the Physicians’ Clinic in London who recently left the NHS. “There are people with low testosterone who have no symptoms, and people with normal testosterone who do.
“Then there’s the overlap with psychological issues. Many men in this age group are re-evaluating their lives; they may be in relationships or marriages they’ve been in for 30 years, and so, of course, their libido isn’t going to be the same.”
He says that testosterone treatment “is not completely risk-free” – there is a lack of long-term safety data, and some research suggests testosterone raises the risk of heart attacks and strokes.
Testosterone is known as a ”male” hormone, but the idea that it can benefit women is fast gaining ground.
Dr Marion Gluck, an independent hormone specialist on Wimpole Street, has been prescribing the hormone to women for years. “It’s a hugely important hormone for both men and women,” she says. “The levels are totally different – I give women between 0.5 and 2.5mg a day, while men take 25 to 50mg. But both men and women produce it naturally, and need it.”
Roslyn Bell, 49, has been taking testosterone for four years. In her 30s, she underwent a hysterectomy as treatment for cervical cancer, and had been on traditional HRT since, but suffered badly with forgetfulness, low mood and fatigue, which had led to her gaining weight. She saw Dr Gluck and switched to a new HRT regimen that included testosterone.
“My initial reaction was ‘Am I going to grow a beard?’?” says Bell, who runs a property business and is married with twins, aged 28. “But I tried it, and after three months started to feel so much better. I started sleeping better and exercising more. I’ve lost about two stone.”
Patients such as Bell may have benefited from taking testosterone, but should it be offered to all women suffering with low libido, as one gynaecologist recommended last week?
Ultimately, the debate raises a fundamental question about our expectations of ageing. “This feeling you can still feel great and full of vitality until the end of your days has caught on,” says Dr Vanderpump. “And I think there’s a lot of pressure on GPs now. We’ve created a consumer-driven medical environment where if the consumer says ‘that’s what I want’, it’s difficult to say no.”
Testosterone without a prescription
- Hit the hay: researchers at the University of Chicago found men who were sleep-deprived (having slept for only five hours) showed a 10 to 15 per cent drop in testosterone compared with when they were fully rested.
- Reduce sugar: US research on 1,822 men found their waist circumference was a strong predictor of their testosterone levels. Cutting down on sugar has been shown to reduce belly fat; this also lowers your risk of type 2 diabetes, which is linked to low testosterone.
- Lift weights: exercise, independently of its effects on weight, has been shown to improve the circulation of free testosterone in the body. Aim for a mixture of cardiovascular activity, such as walking, and weight training. However, don’t work out for more than 60 minutes: overtraining triggers the production of the stress hormone cortisol, which cancels out testosterone.
- Breakfast on eggs with mushrooms: the body needs cholesterol to make testosterone – eggs are a good source, while mushrooms provide magnesium, which is important for testosterone production.
- Get plenty of “good” fats from oily fish and nuts, too.
The Telegraph, London
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